FSIS and the National Antimicrobial Resistance Monitoring System (NARMS): The Public Health Impact of NARMS
Cameron Carow, Gamola Fortenberry, Uday Dessai, Catherine Rockwell, Bonnie Kissler and Sheryl Shaw, USDA Food Safety and Inspection Service
The U.S. Department of Agriculture’s (USDA) Food Safety and Inspection Service (FSIS) in-plant personnel are responsible for inspection of meat, poultry and egg products. The work of food inspectors, consumer safety inspectors and public health veterinarians (PHV) within regulated establishments is critical to the vision of the agency — ensuring that everyone’s food is safe. Their daily duties are wide-ranging, from verifying the humane handling and slaughter of food animals, inspecting animals before and after slaughter, to verifying that establishments operate in a sanitary manner to prevent contamination or adulteration of products. In doing so, in-plant personnel contribute to reducing pathogens in regulated food products. In addition, our in-plant personnel collect animal cecal content samples for the FSIS National Antimicrobial Resistance Monitoring System (NARMS) program so we can keep an eye on antimicrobial resistance (AMR) and the changes that may be of concern over time. This is an important function, as AMR microbes can reduce the effectiveness of antimicrobial drugs and may lead to treatment failures in humans and animals.
During the last two decades, AMR has been a focus for USDA due to the dual threat it poses to animal agriculture and public health. These overlapping interfaces make AMR a challenge that requires a One Health approach. One Health emphasizes the relationship between the health of humans, animals, plants and the environment. It recognizes that achieving optimal health outcomes requires a collaborative approach. NARMS is an interagency program that embodies One Health through a partnership between FSIS, the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). FSIS collects samples from food animals at slaughter and processing establishments from cecal (intestinal) contents and products from routine verification sampling Concurrently, the FDA collects samples from retail meats sold to consumers. The CDC, state and local public health partners collect samples from ill humans, whether sporadic cases or from outbreaks.
FSIS in-plant personnel play a key role in the NARMS program through their sample collection activities. The samples collected by in-plant personnel provide us with important insights into food safety, trends and changes in bacteria and serotypes, as well as emerging AMR patterns of public health concern. For example, a multidrug-resistant (MDR) strain of Salmonella Infantis was first detected in the U.S. during NARMS routine sampling of retail chicken products by the FDA in 2014. NARMS cecal and product samples collected by FSIS in-plant personnel found the same strain of Salmonella Infantis and associated MDR represented a rapidly growing percentage of Salmonella found in chicken. By 2018, the strain accounted for about 25% of Salmonella Infantis infections in people. The appearance of this MDR strain of Salmonella demonstrates how quickly new AMR threats can emerge and the importance of surveillance to detect and respond to them. As FSIS works towards its target of reducing Salmonella infections linked to FSIS-regulated products, the product and cecal samples taken by FSIS in-plant personnel provide valuable insights by tracking serotypes and emerging AMR threats of public health concern.
For more information on NARMS, visit the FSIS NARMS webpage. While FSIS and the other federal partners actively engage in the AMR work, consumers should remain vigilant about pathogens in their foods. To protect individuals and families from foodborne pathogens, FSIS recommends the four safe food preparation steps: Clean, Separate, Cook and Chill.